When an opening in tissue is created either through an intentional incision or an accidental wound or laceration, biological healing of the opening commences through the proximity of the opposed living tissue surfaces. If the opening is very large or if its location subjects the wound to continual movement, a physician will seek to forcibly hold the sides of the opening in close proximity so as to promote the healing process.
A variety of surgical methods and devices are currently employed in forcibly closing and approximating tissue openings throughout the healing process. Examples include the use of elastic skin closures, sutures, staples, adhesive dressings and skin glue. Regardless of their construction or method of use, these wound closure modalities all seek to positively retain living tissue on opposed sides of the opening in closed relation throughout the healing process.
In general, use of the aforementioned wound closure modalities necessitates that a medical professional manipulate and/or approximate opposed sides of the tissue wound prior to and/or during deployment of the wound closure modality. In many situations, the medical professional uses one or more surgical forceps to grasp and retain the tissue during application of the wound closure modality. A typical surgical forceps can comprise a pair of grasping arms that are operably joined at an apex such that arm tips located distally from the apex can be brought into proximity by squeezing the grasping arm together. This typically requires two medical professionals to successfully achieve wound closure; one for tissue approximation and one for fastener deployment. In other alternative configurations such as, for example, configurations disclosed in U.S. Pat. No. 2,214,984 to Bachmann, U.S. Pat. No. 4,950,281 to Kirsch et al., U.S. Pat. No. 5,520,704 to Castro et al., U.S. Pat. No. 5,565,004 to Christoudias and U.S. Pat. No. 6,283,984 to Ray, a surgical forceps can comprise two grasping arms and a central arm such that both sides of tissue wound can be grasped and retained with a single forceps.
One recent advance in the field of wound closure comprises a bilateral wound closure method in which a bioabsorbable fastener is positioned for deployment within target tissue zones, defined within the dermal layers on opposed sides of a wound interface. Once deployed, the bioabsorbable fastener is not externally visible and no follow-up visit is required to remove the fastener once the wound has healed. This bilateral wound closure approach is commercially available as the Insorb® Subcuticular Skin Stapler manufactured by Incisive® Surgical, Inc. of Plymouth, Minn., and is described in U.S. Pat. No. 6,726,705, as well as in a series of pending U.S. patent applications Ser. Nos. 10/448,838 and 10/607,497, all of which are herein incorporated by reference to the extent not inconsistent with the present disclosure.
Through the development of the aforementioned bilateral wound closure approach, it has been discovered that the targeted dermal tissue can have a multitude of variables that effects the ability to effectively approximate tissue for purposes of effecting a wound closure. These variables can comprise thickness, stretch, and strength and can vary based upon the wound's location on the body, the patient's body type as well as the patient's age. As such, it would be advantageous to further improve on the ability to effectively close wounds by having an apparatus and method of implementing said apparatus so as to consistently manipulate and present a wound to a closure instrument.